The pelvis is the lowest anatomical region of the trunk. Being a cavity, the pelvis forms a bony and muscular funnel that narrows downward. It is bounded by the sacrum, coccyx, ilia and coccyx (which form the pelvic girdle) and the muscles of the lower abdominal wall and perineum.
The female pelvis contains the final part of the intestine (sigmoid colon and rectum), the urinary bladder, the ovaries, the fallopian tubes, the uterus and vagina.
The male pelvis also contains the final part of the bowel (sigmoid colon and rectum), the urinary bladder, and the male sex organs which are the prostate and seminal ducts.
Chronic pelvic pain is usually of unknown cause. There may be various expressions of it, such as anal or rectal pain, perineal pain, scrotal or male reproductive tract pain, vaginal pain or vulvodynia, lower abdominal pain with bladder spasms (often reflecting interstitial cystitis), and other more complex forms of presentation.
Very often pain predominates in one region but there is also variable pain in other areas. It may also occur that over time the location of pain varies in the same patient.
Pelvic pain is often chronic, difficult to diagnose and responds inadequately to treatment. In many cases it is impossible to determine the cause despite the many studies that are performed. It is often a cause of frustration and discouragement for both the sufferer and physicians, and is often accompanied by depressive symptoms and anxiety.
Several therapeutic options are currently available to treat chronic pelvic pain. These include hypogastric plexus block, spinal cord stimulation and sacral nerve stimulation.